| NPI | 1740515162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MD 2V2973) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT195970) |
| 208600000X Surgery (Licence: FL ME128282) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: MD 2V22952) | |
| Enumeration Date | 2009-10-03 |
| Last Update Date | 2023-08-14 |